| Sidney Medical Group Inc | |
|
322 Second Avenue Sidney OH 45365 | |
| (937) 492-9128 | |
| (937) 497-0820 |
| Full Name | Sidney Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 322 Second Avenue, Sidney, Ohio |
| Authorized Official Name and Position | Robert J Miller (OWNER) |
| Authorized Official Contact | 9374929128 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sidney Medical Group Inc 322 Second Avenue Sidney OH 45365 Ph: (937) 492-9128 | Sidney Medical Group Inc 322 Second Avenue Sidney OH 45365 Ph: (937) 492-9128 |
| NPI Number | 1164523882 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164523882 | NPI | - | NPPES |
| 0305539 | Medicaid | OH | |
| 2435930 | Medicaid | OH | |
| 0905784 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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